ArticleAIDS (London, England)2017
Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women.
Article in AIDS (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Approaches to transitioning women into and out of prevention of mother-to-child transmission of HIV services for continued ART: a systematic review.Journal of the International AIDS Society · 2021Pooled it
- Predictors of Viremia in Postpartum Women on Antiretroviral Therapy.Journal of acquired immune deficiency syndromes (1999) · 2020Trial
- Article
- High rates of viral suppression in pregnancy drop postpartum in South African women on tenofovir-lamivudine-dolutegravir: a prospective cohort study.Journal of the International AIDS Society · 2025Article
- ART history prior to conception: trends and association with postpartum disengagement from HIV care in Khayelitsha, South Africa (2013-2019): a retrospective cohort study.Journal of the International AIDS Society · 2024Article
- Association of comprehensiveness of antiretroviral care and detectable HIV viral load suppression among pregnant and postpartum women in the Democratic Republic of the Congo: a cross-sectional study.Frontiers in global women's health · 2024Article
- Viral suppression and retention in HIV care during the postpartum period among women living with HIV: a longitudinal multicenter cohort study.The Lancet regional health. Europe · 2023Article
- Relating CYP2B6 genotype and efavirenz resistance among post-partum women living with HIV with high viremia in Uganda: a nested cross-sectional study.AIDS research and therapy · 2023Article
- Incidence and predictors of loss to follow-up among pregnant and lactating women in the Option B+ PMTCT program in Northwestern Ethiopia: a seven-year retrospective cohort study.Frontiers in global women's health · 2023Article
- The Psychosocial Profile of Women Who Defaulted Option B+ HIV Treatment: An Interpretive Phenomenological Analysis Study.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Cost-effectiveness of broadly neutralizing antibody prophylaxis for HIV-exposed infants in sub-Saharan African settings.Journal of the International AIDS Society · 2023Article
- Retention in care and viral suppression in the PMTCT continuum at a large referral facility in western Kenya.AIDS and behavior · 2022Article
- Article
- Optimizing Pharmacology Studies in Pregnant and Lactating Women Using Lessons From HIV: A Consensus Statement.Clinical pharmacology and therapeutics · 2021Article
- Differential impact of antiretroviral therapy initiated before or during pregnancy on placenta pathology in HIV-positive women.AIDS (London, England) · 2021Article
- Social Support Mitigates Negative Impact of Food Insecurity on Antiretroviral Adherence Among Postpartum Women in Western Kenya.AIDS and behavior · 2020Article
- Adherence to HIV antiretroviral therapy among pregnant and postpartum women during the Option B+ era: 12-month cohort study in urban South Africa and rural Uganda.Journal of the International AIDS Society · 2020Article
- Antiretroviral Adherence, Elevated Viral Load, and Drug Resistance Mutations in Human Immunodeficiency Virus-infected Women Initiating Treatment in Pregnancy: A Nested Case-control Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Incidence and predictors of lost to follow-up among women under Option B+ PMTCT program in western Ethiopia: a retrospective follow-up study.BMC research notes · 2020Article
- Impact of a Maternal Prevention of Mother-to-child Transmission of HIV (PMTCT) Intervention on HIV-exposed Infants in Uganda.International journal of MCH and AIDS · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe assessed the association between the timing of pregnancy with the risk of postpartum virologic failure and loss from HIV care in South Africa.
designThis is a retrospective cohort study of 6306 HIV-positive women aged 15-49 at antiretroviral therapy (ART) initiation, initiated on ART between January 2004 and December 2013 in Johannesburg, South Africa.
methodsThe incidence of virologic failure (two consecutive viral load measurements of >1000 copies/ml) and loss to follow-up (>3 months late for a visit) during 24 months postpartum were assessed using Cox proportional hazards modelling.
resultsThe rate of postpartum virologic failure was higher following an incident pregnancy on ART [adjusted hazard ratio 1.8, 95% confidence interval (CI): 1.1-2.7] than among women who initiated ART during pregnancy. This difference was sustained among women with CD4 cell count less than 350 cells/μl at delivery (adjusted hazard ratio 1.8, 95% CI: 1.1-3.0). Predictors of postpartum virologic failure were being viremic, longer time on ART, being 25 or less years old and low CD4 cell count and anaemia at delivery, as well as initiating ART on stavudine-containing or abacavir-containing regimen. There was no difference postpartum loss to follow-up rates between the incident pregnancies group (hazard ratio 0.9, 95% CI: 0.7-1.1) and those who initiated ART in pregnancy.
conclusionThe risk of virologic failure remains high among postpartum women, particularly those who conceive on ART. The results highlight the need to provide adequate support for HIV-positive women with fertility intention after ART initiation and to strengthen monitoring and retention efforts for postpartum women to sustain the benefits of ART.
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